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General NPI Number Information
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NPI Number | 1609461318
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Entity Type | Individual
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Provider Name | HECTOR ALICEA RBT
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Gender | Male
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 114 DEL PRADO BLVD S
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City | CAPE CORAL
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State | FL
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Zip | 33990-1724
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Country | US
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Telephone | 239-888-0561
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Fax |
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Provider Business Mailing Address
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Address Line | 1406 SW TRAFALGAR PKWY
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City | CAPE CORAL
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State | FL
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Zip | 33991-3289
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Country | US
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Telephone | 203-343-1868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-110
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License Number State | CT
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